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India’s fight against AIDS to focus on gays

MEXICO CITY: Men who have sex with men (MSMs) are posing to be India’s greatest challenge in its fight against AIDS.

An alarming increase in the number of gay men and a tremendous spike in the prevalence of HIV within this community has now made the country’s National AIDS Control Organisation (Naco) decide to increase prevention interventions for this community by almost six times by the end of 2008.

Naco estimates that India is home to 2.5 million MSMs of which 100,000 are at high risk of contracting HIV due to multi-partner and commercial sexual practices. Already, 15% of this community have got infected with the deadly disease. The worlds top political leaders and scientists, attending the International AIDS Conference here, including Ban Ki-Moon, Margaret Chan, Peter Piot and presidents from Africa and Latin America, have all called upon governments to immediately target and control the epidemic among MSMs.

Scientific evidence presented at the conference said MSMs were 19 times more likely to be infected with HIV than the general population. A report launched by the American Foundation for AIDS Research studied 128 country reports and found that nearly half (44%) failed to provide any data on MSMs.

The report painted a clear picture of collective denial and inaction fuelling a worldwide public health crisis.

Smarajit Jana, Nacos national programme officer for targeted interventions, told TOI, "MSMs are a very high risk community in India. At present, India has 800 targeted interventions of which 200 are for MSMs. Under NACP III, out of Indias 2,100 TIs planned, 600 will be for MSMs. We are mapping Indias MSM population in 17 states, which we will know by August-end."

Jana added, "Because these communities are suspicious of outsiders, we have decided to let MSM communities run the TIs on their own. Till now, TIs – covering behavioural change education, services to treat sexually transmitted infections, providing condom and lubricants, linking them with integrated counselling and testing centres and providing them with ART if infected – have managed to reach 70% MSMs in southern states. Our main worry is the states in northern India where TI coverage is just 20%."

Naco has identified nine NGOs who will each run TIs for MSMs in two states. India believes that 5% of all sexually active males in India have sex with other men, with Tamil Nadu, Andhra Pradesh and Orissa reporting the highest number of cases. Studies have earlier found HIV infection rates as high as 16% among MSMs in India with prevention programmes available to only 2% of MSMs. "We need to engage MSMs. we need to take care of them and we should not forget them," WHO director-general Margaret Chan said. "In every major city in Asia, there are now epidemics of HIV among MSMs," Peter Piot, outgoing DG of UNAIDS, warned.